What term describes the criteria determining patient eligibility for 340B pricing?

The term that describes the criteria determining patient eligibility for 340B pricing is best captured by the concept of "eligibility criteria." This term encompasses the specific qualifications that patients must meet to benefit from the discounts provided under the 340B Program. Key aspects of these criteria include the patient’s demographics, insurance status, and relationship with the covered entities.

Understanding eligibility criteria is critical for ensuring that the program's benefits are utilized correctly and that only qualified patients receive the discounted medications. These criteria are established to comply with federal regulations and ensure that the program supports the intended populations effectively.

While "patient definition" might seem to imply a similar concept, it does not specifically capture the formal criteria and regulatory frameworks used to establish eligibility, which is why "eligibility criteria" is the more precise term. The other options focus on different aspects of the healthcare reimbursement landscape—pricing structures relate to how prices are set, and reimbursement guidelines focus on how providers get paid for services—which do not define patient eligibility for the 340B discounts.